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Schedule
This program will be formatted as a traditional one and a half days in-person program - we are excited for attendees to connect and network in person. The program will begin on Monday, May 9 at 12:00 noon and end on Tuesday, May 10 at 5:00 pm.
AHLA is committed to providing a safe and healthy environment for program participants and staff. AHLA has adopted preventative measures to reduce the potential spread of the COVID-19 virus, including requiring proof of vaccination, and is following guidance provided by the US Centers for Disease Control and local authorities. Attendees are also expected to do their part and abide by AHLA’s Duty of Care.
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12:00-5:00 pm |
Registration and Check-In |
1:00-2:15 pm | ||||
Welcome and Introduction Cindy Reisz, AHLA President Ankur Goel, Program Planning Committee |
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1. What’s Happening in Health Care–Update on Federal and State Policy
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2:30-3:30 pm | ||||
2. Disruption and Innovation: The Forces Changing Health Care Delivery and Payment
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3:45-5:00 pm | ||||
3. The Future is Now: Managed Care Enforcement Trends and Risk Areas This presentation will provide in-house counsel, compliance officers, and health care attorneys with an overview of the constantly evolving world of managed care and the risk areas being identified. This includes topics such as Medicare Advantage, the risk adjustment reimbursement process, key False Claims Act investigations and settlements, Part D oversight, and compliance dangers in federal and state level managed care programs. Members of the audience will hear directly from HHS-OIG about its oversight tools and developing areas of compliance risk seen through cases around the country. We will dig deep into the current enforcement theories and HHS-OIG Reports to educate the audience about how best to mitigate risk.
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5:00-6:00 pm | ||||
Networking Reception, sponsored by BRG This event is included in the program registration. Attendees and faculty are welcome. |
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7:00 am-5:00 pm | ||||
Registration and Check-In |
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7:00-8:00 am | ||||
Continental Breakfast, sponsored by BRG |
8:00-9:00 am | ||||
4. Drug Pricing: Legislative and Regulatory Developments The past few years have featured a flurry of legislative action, agency rulemaking and executive orders targeting the pricing of pharmaceutical and biologic products, with various legal proposals and potentially significant implications for health plans. This presentation takes stock of legislative and regulatory drug pricing developments–what’s happened, what’s been delayed, and what’s likely to happen–both in 2022, and during the remainder of President Biden’s first term. Specifically, the presentation will address:
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5. Transforming the Patient Experience: The Continued Evolution and Integration of Clinical Care and Retail Settings
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6. The Process of Parity: Mental Health Parity and Addiction Act (MHPAEA) Compliance and Enforcement Considerations for the Health Plan The requirements around the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) continue to evolve, and the law continues to gain national attention. Because of its vast reaching scope, MHPAEA is a law that every health plan lawyer should be familiar with. This presentation will offer:
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9:15-10:15 am | ||||
7. Managed Care Audits
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8. State PBM Laws – When Are They Preempted? In December 2020, the Supreme Court decided Rutledge v. PCMA and held that an Arkansas drug pricing law was not preempted by ERISA. In the ensuing months, numerous states have upped the ante on PBM legislation and regulation. More preemption challenges have followed. In this session, Elizabeth Moellering and Kristyn DeFilipp will discuss this phenomenon and the current status of preemption and state PBM laws, including:
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9. New Antitrust Compliance Risks Facing Health Plans The health care industry is facing increasing antitrust attention from federal and state regulators, as well as private plaintiffs. This session addresses some key areas of potential antitrust risk for health plans and ways to mitigate against them, including:
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10:15-10:45 am | ||
Coffee Break, sponsored by Ankura |
10:45-12:00 noon Extended Sessions | ||||
10. Evolution of Value-based Arrangements for Providers and Plans
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11. No Surprises Act: Lessons Learned from the First Year of Implementation The No Surprises Act (NSA), which was implemented beginning January 1, 2022, fundamentally reshapes how health plans reimburse out-of-network providers for emergency care and out-of-network providers at an in-network facility. State laws in many states already provided patients some protection from surprise medical billing, and the NSA introduced a complicated new preemption analysis about how these state laws interact with the NSA. Further, the NSA introduces a broad range of additional new health plan obligations, including relating to provider directories, insurance ID card information, and advanced explanation of benefits. This session will provide:
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12. Health Equity and Nondiscrimination: The Power and Promise of ACA Section 1557
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12:00-1:00 pm | ||||
Lunch on your own | ||||
1:15-2:15 pm | ||||
13. Legal Ethics: Protecting In-House and Outside Counsel We’ll discuss the following “hot” topics in legal ethics and address common traps for both in-house and outside counsel:
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5. Transforming the Patient Experience: The Continued Evolution and Integration of Clinical Care and Retail Settings
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9. New Antitrust Compliance Risks Facing Health Plans The health care industry is facing increasing antitrust attention from federal and state regulators, as well as private plaintiffs. This session addresses some key areas of potential antitrust risk for health plans and ways to mitigate against them, including:
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2:30-3:30 pm | ||||
14. COVID-19 Testing: Emergency Rules Compliance, Litigation Risks, and Fraud The presentation will include in-house and outside counsel perspectives on:
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6. The Process of Parity: Mental Health Parity and Addiction Act (MHPAEA) Compliance and Enforcement Considerations for the Health Plan The requirements around the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) continue to evolve, and the law continues to gain national attention. Because of its vast reaching scope, MHPAEA is a law that every health plan lawyer should be familiar with. This presentation will offer:
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8. State PBM Laws – When Are They Preempted? In December 2020, the Supreme Court decided Rutledge v. PCMA and held that an Arkansas drug pricing law was not preempted by ERISA. In the ensuing months, numerous states have upped the ante on PBM legislation and regulation. More preemption challenges have followed. In this session, Elizabeth Moellering and Kristyn DeFilipp will discuss this phenomenon and the current status of preemption and state PBM laws, including:
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3:45-5:00 pm | ||||
10. Evolution of Value-based Arrangements for Providers and Plans
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11. No Surprises Act: Lessons Learned from the First Year of Implementation The No Surprises Act (NSA), which was implemented beginning January 1, 2022, fundamentally reshapes how health plans reimburse out-of-network providers for emergency care and out-of-network providers at an in-network facility. State laws in many states already provided patients some protection from surprise medical billing, and the NSA introduced a complicated new preemption analysis about how these state laws interact with the NSA. Further, the NSA introduces a broad range of additional new health plan obligations, including relating to provider directories, insurance ID card information, and advanced explanation of benefits. This session will provide:
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12. Health Equity and Nondiscrimination: The Power and Promise of ACA Section 1557
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In-Person Program Format
How It Works
- We will offer in-depth breakout sessions where speakers and attendees can interact and collaborate with each other in-person.
- We consider the health and safety of all those onsite at in-person programs our top priority. AHLA will follow guidance and requirements issued by the CDC as well as by state and local government and are working with the hotel to ensure your health and safety as we transition back to in-person programming.
- All attendees, who register for the in-person program, will be required to commit to our Duty of Care agreeing to follow the protocols we establish and monitor their own health for the health and safety of all.
- To minimize crowding, we are offering extended time for registration. We have adopted a new onsite registration system by providing seamless, touchless check-in, onsite badge printing, and safety supplies to all attendees to use while in attendance.
- Built-in extended time between sessions for moving from room to room, networking with colleagues, and personal breaktime.
- Socially distanced seating arrangements in breakout rooms, regular cleaning in and around meeting spaces, and appropriate signage/floor decals to reinforce spatial distancing and other safety reminders.
- The program sessions will be recorded. Audio of the presentations, along with the materials will be available for purchase after the program. More information on our ePrograms.
Benefits of the In-Person Program
- After a year of virtual programming, you will finally be able to step out from behind your computer and network face-to-face with other health law professionals.
- Interact with colleagues at in-depth breakout sessions.
This program will be formatted as a traditional one and a half day in-person program - we are excited for attendees to connect and network in person.
AHLA is committed to providing a safe and healthy environment for program participants and staff. AHLA has adopted preventative measures to reduce the potential spread of the COVID-19 virus, including proof of vaccine or a negative PCR test, and is following guidance provided by the US Centers for Disease Control and local authorities. Attendees are also expected to do their part and abide by AHLA’s Duty of Care.
Program Accessibility and Special Needs
AHLA is committed to ensuring equitable access to our educational content. We are continually improving the user experience for everyone and offering accessibility accommodations for our in-person programs.
Program Accessibility and Special Needs
AHLA is committed to ensuring equitable access to our educational content. We are continually improving the user experience for everyone and offering accessibility accommodations for our in-person programs.